NPIMap

Individual provider Active NPI

Lee Edwin Faulkner, M.D.

  • Cardiovascular Disease Physician
  • Memphis, TN
National Provider Identifier
1992735641
Registry record updated Mar 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
MD0000028255 Issued in TN
Practice address
6005 Park Ave Ste 702
Memphis, TN 38119-5217
Phone
(901) 682-7241
Fax
(901) 682-7243
NPI assigned
Jul 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X MD0000028255 TN Primary

Addresses

Primary practice location

6005 Park Ave Ste 702
Memphis, TN 38119-5217

Mailing address

6005 Park Ave Ste 702
Memphis, TN 38119-5217
Phone (901) 682-7241

Other identifiers 1

IdentifierTypeStateIssuer
3803983MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090115000761 TN Practitioner - Cardiovascular Disease (Cardiology) 2860555976 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6005 Park Ave
Suite 702
Memphis, TN 38119-5217
Phone (901) 682-7241

Hospital & facility affiliations

  • St Francis Hospital Hospital, Memphis, TN, CCN 440183
  • Baptist Memorial Hospital Hospital, Memphis, TN, CCN 440048
  • Methodist Hospitals of Memphis Hospital, Memphis, TN, CCN 440049
  • Baptist Memorial Hospital Desoto Hospital, Southaven, MS, CCN 250141

Merit-based Incentive Payment System (MIPS)

Final score
82.75 of 100Reported as individual
Quality
59.93
Improvement activities
40
Cost
78.78

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD0000028255TNMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians of Hearts P.L.L.C. Specialist CurrentSince Sep 20, 2008 Accepting new patients
Majestic Operations LLC Past Accepting new patients
Proactive Heart & Vascular, PLLC Single Specialty PastSince Aug 1, 2008 Accepting new patients

Locations

6005 Park Ave
Ste 702
Memphis, TN 38119
Phone (901) 362-8884

5959 Park Ave
Memphis, TN 38119
Phone (901) 765-1000

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HIAECD/Endpoint/HIAECD
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • FHIR API: https://fhir4.healow.com/fhir/r4/HIAECD

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583280000000",
    "number": "1992735641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6005 PARK AVE STE 702",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381195217",
            "telephone_number": "901-682-7241",
            "fax_number": "901-682-7243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6005 PARK AVE STE 702",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381195217",
            "telephone_number": "901-682-7241",
            "fax_number": "901-682-7243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAULKNER",
        "first_name": "LEE",
        "middle_name": "EDWIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2020-03-04",
        "certification_date": "2020-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TN",
            "license": "MD0000028255",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3803983",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.